Nokea
All the following are true regarding coarctation of the aorta EXCEPT
- A. notching of ribs is noted
- B. doppler is useful for demonstrating severe obstruction
- C. diagnostic catheterization is mandatory before surgery
- D. CT and MRI are valuable noninvasive tools for evaluation when the echocardiogram is equivocal
Correct Answer: C
Rationale: Diagnostic catheterization is not always mandatory before surgery for coarctation of the aorta.
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A 12-year-old child whose body mass index (BMI) is greater than the 95th percentile has a blood pressure at the 98th percentile for age, sex, and height. After lifestyle changes that include diet and exercise, the child's BMI drops to the 90th percentile, but the blood pressure remains the same. What is the primary care pediatric nurse practitioner's next step in treating this child?
- A. Continued close monitoring of blood pressure
- B. Ordering an echocardiogram
- C. Prescribing an ACE inhibitor medication
- D. Referral to a nephrologist or cardiologist
Correct Answer: D
Rationale: Children who have persistent BP elevation after lifestyle changes are made should be referred to a nephrologist or cardiologist who has experience using antihypertensive agents in children.
All the following are signs of coarctation of the aorta EXCEPT
- A. femoral pulses are weak or absent
- B. bounding pulses of the arms
- C. blood pressure in the legs is lower than that in the arms
- D. precordial impulse and heart sounds are usually normal
Correct Answer: B
Rationale: In coarctation of the aorta, femoral pulses are delayed or absent, not bounding.
A client with ulcerative colitis is admitted to the medical unit during an acute exacerbation. The nurse should instruct the unlicensed assistive personnel (UAP) to report which finding related to the client's bowel movements?
- A. Hard pellets of stool
- B. Clay-colored stool
- C. Stool with fatty streaks
- D. Blood in the stool
Correct Answer: D
Rationale: Blood in the stool is a common finding during an acute exacerbation of ulcerative colitis, which is an inflammatory condition of the colon.
List THREE medical management plans for biatrial enlargement.
- A. Loop diuretics (carefully)
- B. Beta-blockers (carefully)
- C. Anticoagulation
- D. All of the above
Correct Answer: D
Rationale: These are standard treatment options aimed at managing heart function, reducing fluid buildup, and preventing complications like clot formation.
In Wilson's disease:
- A. There is an association with high caeruloplasmin levels
- B. Hepatic copper deposition is pathognomonic
- C. There is increased urinary excretion of copper
- D. There are copper deposits on the cornea
Correct Answer: D
Rationale: Copper deposits on the cornea (Kayser-Fleischer rings) are a hallmark of Wilson's disease, a genetic disorder leading to copper accumulation in tissues.